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High standards of care, but issues remain in some areas, Healthcare Inspectorate Wales finds in its latest Annual Report

In its annual report published today [Thursday 22 October] Healthcare Inspectorate Wales (HIW) has summarised the findings of over 200 inspections and reviews published during 2019-20 and prior to the onset of the Covid-19 pandemic.

As the organisation that checks that people in Wales are receiving good quality healthcare, we inspect a wide range of services including hospitals, dentists, clinics, community mental health teams and mental health units, and GP surgeries across Wales’s seven NHS health boards and the independent healthcare sector.

It is important to highlight that work covered in the annual report was undertaken prior to the COVID-19 pandemic. The report’s publication was delayed due to measures we took to reduce the burden of our work on services during the height of the pandemic. As such, our annual report does not examine how health services in Wales have undertaken their role during the pandemic.

We generally saw a high standard of care in our inspection work across the NHS and independent sectors. There are still, however, recurring themes from our work before the arrival of the coronavirus pandemic which we’ve highlighted.

The management of medicines and safe storage is still an issue in some wards and in GP practices. Infection prevention and control standards are not always met and resuscitation equipment is at times not maintained.

In GP practices, we found that DBS checks are not always carried out and that record keeping in relation to staff immunisation could be improved in some cases. Patients also reported problems booking appointments to see a family doctor.

The findings from our dental inspections were very positive on the whole. However, we identified a range of improvements in the area of infection prevention and control and in ensuring that suitable arrangements are in place to protect patients and staff in a medical emergency.

We received assurances in a timely manner, but it is frustrating that many of the issues requiring immediate attention were the same as those identified in previous years.

Maintenance and refurbishment of wards was an issue in many of our mental health inspections and the quality of care plans varied considerably.

Our review work, where we take a broader look at how services are delivered, saw us inspect a complex, integrated care system in relation to falls services. We also worked jointly with Audit Wales on an urgent joint review of governance arrangements at the former Cwm Taf University Health Board. Acting upon intelligence that indicated failings in quality governance and maternity services, the review highlighted a number of fundamental issues and weaknesses. It made recommendations for improvement that are now being implemented and follow-up work is being planned.

Concerns about maternity services led to us beginning a national review of such services across Wales, which is due to report by the end of this year.

Alun Jones, the Interim Chief Executive of Healthcare Inspectorate Wales, said:“In our inspection work across the NHS and independent sectors, we generally saw a high standard of care, but there are still recurring themes from our work which we’ve highlighted in years past. It is a frustration to see issues we’re previously talked about continue to crop up in our work.

But I’m pleased that in the second year of our three-year strategy, we were able increase our activity and improve our ability to act in light of emerging evidence. We have built on a solid foundation to help us deliver our goal of encouraging improvement in healthcare by doing the right work at the right time in the right place, and ensuring what we do is communicated well and makes a difference.

The public and healthcare professions can help by telling us about their own experiences of healthcare services, and by speaking up if they feel they need to. Information and intelligence are key to us being effective in our role.

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